Effectiveness of a simplified method for final impression in complete denture treatment: A pragmatic clinical trial.

PURPOSE: This study aimed to compare two methods for final impression during the fabrication of complete dentures: a traditional method using custom trays (T-group) and a simplified method using the trial denture baseplate (S-group). METHODS: A pragmatic clinical trial was conducted among edentulous individuals referred for conventional denture treatment. A consecutive sample of edentulous patients was assigned to two groups by cluster randomisation according to the final impression strategy, 30 in the T-group and 38 in the S-group. In the T-group, an auto-polymerising acrylic resin custom tray was used for impression; in the S-group, the final impression was performed using the try-in dentures. For both groups, zinc oxide eugenol paste was used as the impression material. The quality of the dentures was assessed using two rating scales (Functional Assessment of the Dentures and Kapur method). Moreover, clinical time for denture fabrication, number of post-insertion appointments for adjustments, patient satisfaction and post-treatment oral health-related quality of life impacts were also assessed. RESULTS: There were no significant differences between groups regarding prosthodontic and patient-reported outcomes. The S-group demanded less clinical time (P = 0.002), with a 23.3% mean reduction in clinical time (P = 0.002) and lower number of appointments until the delivery of the dentures (S-group = 4.18 vs T-group = 5.0; P = 0.001). CONCLUSIONS: This study showed that the alternative method for final impression is less time-consuming and has similar clinical outcomes when compared to the traditional final impression method. Findings suggest that this alternative may be considered when efficiency is a critical issue in healthcare services.

Impact of patient characteristics on edentulous subjects' preferences for prosthodontic rehabilitation with implants.

OBJECTIVE: The aim of this study was to assess the influence of patient characteristics on edentulous subjects' preferences for different prosthodontic treatments with implants. MATERIALS AND METHODS: A cross-sectional study was carried out with 131 edentulous subjects referred for treatment at a university clinic. Participants received detailed information about available treatment options and were asked to rank their preferences among three alternatives for rehabilitation of the maxilla and mandible: conventional dentures (CD), 2-implant-retained overdentures (IOD), or 4-implant fixed dentures (IFD). Individual data and prosthodontic-related variables were assessed through interviews. Oral health-related quality of life impacts was measured using the Brazilian version of the Oral Health Impact Profile for edentulous subjects (OHIP-Edent). Descriptive statistics, bivariate tests, and binary and multinomial logistic regressions were used for data analysis. RESULTS: The majority of participants chose CD as their most preferred treatment for the maxilla (45.8%), while IFD was the most prevalent choice for the mandible (38.9%). Regression analysis showed that the OHIP-Edent "oral pain and dysfunction" (OPD) domain scores were positively associated with IOD preference for the maxilla (OR = 1.31; p = 0.010) and mandible (OR = 1.46; p = 0.002) and with IFD preference for the mandible (OR = 1.20; p = 0.031). Subjects with lower levels of formal education and those with lower income levels were less likely to choose IFD. CONCLUSION: Level of education, income, and perceived quality of life impacts are potentially predictive variables of edentulous patients' preference for rehabilitation with implants. These factors may constitute important aspects to be considered by clinicians when treatment planning for edentulous patients.

Changes in masticatory performance of edentulous patients treated with single-implant mandibular overdentures and conventional complete dentures.

OBJECTIVES: The aim of this study was to test the effect of a single-implant mandibular overdenture (SIMO), compared with conventional complete denture (CD), on masticatory performance measured by the mixing ability of a two-coloured chewing gum. METHODS: A sample of edentulous subjects was randomly assigned to the SIMO (n = 15) and CD (n = 19) groups. Patients in both groups received a set of new complete dentures, and the SIMO group received a single implant in the symphyseal region of the mandible (Straumann® Standard Plus SLActive®) and an eliptical matrix and ball attachment for denture retention. Masticatory tests were performed using a two-colour chewing gum (Vivident Fruitswing, Perfetti van Melle, Turkey) for 20 and 50 chewing cycles. Colour-mixing ability was assessed by electronic colourimetric analysis (ViewGum©, Dhal Software, Greece), expressed by the variance of hue. Tests were performed at baseline and at the 6- and 12-month follow-ups. Multilevel linear regression was used to model the changes in masticatory performance. RESULTS: Groups were similar at baseline for 20 and 50 cycles (P > 0.05). A significant linear effect was observed on time points for 20 and 50 cycles (P < 0.001). No difference was observed between treatment groups factor (P > 0.05). However, the way masticatory performance varied according to time points differed in the CD and SIMO groups for 20 cycles (P = 0.048). CONCLUSION: Masticatory performance improved significantly after 12 months, irrespective to the insertion of a single implant to retain a mandibular overdenture. Moreover, results suggest that SIMO treatment may perform better than CD in the shorter follow-up period.